This is a new T32 application from the Division of Pediatric Cardiology of the Department of Pediatrics, Vanderbilt University School of Medicine and the Monroe Carell Jr. Children's Hospital at Vanderbilt. Our long- term goal is to build upon the success of the Division in training academic pediatric cardiologists by developing a program that integrates formal training in research on developmental determinants of cardiovascular disease with clinical training in pediatric cardiology. This training program will not only focus on the molecular and genetic etiologies of congenital heart disease, but will also emphasize the impact of pre- and postnatal development in defining the manifestations of pediatric cardiovascular disease after birth. In addition to trainees in the Pediatric Cardiology, clinical fellows in related Pediatric subspecialties such as Pulmonary Medicine, Critical Care Medicine, and Neonatology as well as Ph.D. post-doctoral fellows who have an expressed interest in investigating development mechanisms of cardiovascular disease will be eligible for support. This program will provide a unique opportunity for trainees to study the recapitulation of normal developmental processes in the ontogeny of cardiovascular pathology presenting later in childhood or adulthood. The program will be composed of two tracks optimized either for pursuit of preparation for (1) basic science investigation or (2) clinical or translational research. A focused laboratory experience with targeted didactic interactions will be tailored to meet the needs of those pursing a more basic science career. For trainees pursuing a career in clinical or translational medicine, the Vanderbilt Master of Science in Clinical Investigation (MSCI) program will be an integral part of the training program. Candidates will primarily be identified from the pool of applicants for pediatric cardiology fellowship (102 applicants for 2 positions in 2010). This proposal will fund the second and third years of fellowship, during which the trainee will carry out the mentored research. During the fourth year, the trainee will complete clinical training with the option of advanced training in a sub-subspecialty as well as continued research and submission of a K08 or K23 application. The Department and Division are committed to funding the first and fourth years of this training. The program directors will use an internal advisory committee, comprised of successful physician-scientists from within Vanderbilt, as well as an external advisory committee that includes experts in both clinical and basic research who are also program directors for current T32 applications in Pediatric Cardiology. Using the unique strengths of Vanderbilt University in the areas of developmental biology, vascular biology, regenerative medicine and tissue engineering, cardiovascular pharmacology and pharmacogenetics, and population as well as outcomes based research, the program will help train the next generation of physician scientists. By including former trainees as Mentors-in-training, the program will assist these junior faculty members in their academic careers as well as maintain a cadre of mentors for the future success of this program.